The routines for blood testing were changed during 2010 at the blood bank in UAS. At first, the blood test was taken before the donation and now it is taken after donation. Along with this, the blood bank increased the lowest level for allowance of blood donation with 10 g/L both for men and women. The level is now on 125 g/L and 135 g/L for women respectively men. After the increase, it was noticed that the amount of blood donors were deferred due to low Hb levels in creased. A study made in year 2013, investigated how much the Hb-levels actually was changed during a blood donation. It showed that it was lowered in means by 6 g/L and not 10 g/L as previously thought.The aim of this study was to see if the sitting position of the blood donor during waiting time and the supine position during the time of blood donation may had any effect on the difference of the Hb-level during the blood donation.Data from the 120 blood donors in the earlier study was collected. Hb values, before and after blood donation, were taken from the earlier study and registered times were taken from the database Prosang. The waiting time, time of blood donation and the difference of Hb-levels were calculated and correlated with Spearmanns correlation coefficient.The results did not show any correlation between the times and the difference in Hb-levels. One of the reasons may be that the blood donor physiology differ and thus the change in Hb-level can vary.

The aim of the current study was divided into two separate goals, (i) optimization of a number of PCR-based protocols employed for genotyping transgenic mouse lines and (ii) evaluating a protocol for co-detection of mRNA and its correlated protein in the mouse midbrain. The optimization was performed on PCR protocols for genotyping the following transgenic mouse lines; Dat-Cre, Vglut2-Lox, Vglut2-Cre and Vmat2-Lox. Also, two different polymerases were evaluated parallel to each other – KAPA and Maxima Hot Start. One of the main findings from the PCR optimizations were that for the Vglut2-Lox protocol. By decreasing the annealing temp and increasing the MgCl2 the bands appeared brighter.  For the second part of the project, in-situ hybridization (ISH) was used to detect the mRNA expression with a `non-radioactive in situ hybridization´ protocol, using digoxigenin or fluorescein labelled riboprobes (mRNA probes). To detect the correlated protein a basic immunohistochemistry (IHC) protocol with the use of primary and secondary antibodies was implemented. The combined protocol was tested with Nd6 and Grp markers. Before testing to combined the protocols the ISH protocol was performed alone with riboprobes for Girk2, Lpl and Fst. The combined protocol detected mRNA and protein for both the control marker Th and the Nd6 marker. In conclusions, the optimized PCR protocols were optimal when used with the Maxima Hot Start polymerase and the new combined ISH and IHC protocol worked for markers Th and Nd6.

I denna studie jämfördes två olika metoder för att analysera cerbrospinalvätska (CSF); spinal-protein och spinal-albumin. Syftet med studien var att undersöka om spinal-albumin som baseras på turbidimetri skulle kunna ersätta spinal-protein som baseras på spektrofotometri. Denna används idag som rutinanalys på laboratoriet för klinisk kemi på S Södra Älvsborgs sjukhus (SÄS). 35 prover analyserades, tagna från det CSF -prover som ankom till SÄS. Varje prov kördes två gånger med respektive metod. Studien visade en god korrelation mellan metoderna, dock visade Bland-Altman diagram mindre spridning av värdena som erhölls med albumin-metoden. Resultaten för albumin jämfördes mot Sahlgrenska universitetssjukhus (SU) resultat, då albumin-metoden ingår i deras rutiner.   Studien visade också att de dagliga kontrollerna som kördes ej var lämpade för albumin metoden, då både innehåll och koncentration inte var anpassad till spinalprover. Kontrollerna kommer att bytas ut mot andra mer lämpade kontroller. Metoden för spinal-albumin kommer att kunna ersätta total-protein som rutinanalys av CFS.

Group A Streptococcus (GAS) is a globally disseminated pathogen that causes >500,000 deaths yearly and is ranked as ninth leading infectious cause of human mortality by the World Health Organisation. The spectrum of disease ranges from superficial infections of the skin and epithelium to invasive and systemic infections. Although the interaction of GAS with neutrophils has been extensively studied much remains to be discovered about the role of macrophages, which are the first line of defence encountered by invading pathogens. In this study, the aim was to establish a means of deriving macrophages from primary monocytes and to study both the efficiency of macrophage killing of GAS and the macrophage cell death response to GAS infection. Here, we report that monocyte-derived macrophages are able to take up and kill GAS during in vitro infection. Production of reactive oxygen species by macrophages was elicited during infection, but not nearly in as high amounts as produced by neutrophils. Investigating the type of cell death induced by GAS, markers for both apoptosis and necroptosis can be found after 8 hours of infection. These results highlight that macrophages indeed are participating in the clearance of GAS and more studies are needed to understand the roles of macrophages in early control of GAS infection.

Treatment of cancers has been improved and new findings in research communities areconstantly found, but there are still many questions about how to treat these complex diseases.One way to treat cancer is to expose cancer cells to drugs that kill the cancer cells to a largerextent than the normal cell from the same as well as other tissue types. Different drugcompounds have diverse molecular effects on the cancer cells and to evaluate them, studies ondifferent cell lines were performed.Experiments were performed to study morphological and metabolic changes on treatedcells. Morphological changes in growing populations of MCF-7 cells and MCF-10A cellswere studied by using a phase contrast video microscopy (IncuCyte) image analysis. Changesin levels of metabolites and proteins were analyzed using two different mass spectrometricmethods. Hierarchical clustering was used to study the relationship between the collectedspectra and the most outstanding subgroup (cluster) was a set of compounds related toestrogens.There were apparent morphological differences between the two different cell lines, bothwhen untreated and after induction of apoptosis. This study shows that, when examining themetabolic patterns, there are tendencies among the substances studied to form clustersaccording their pharmacological classes. Although more studies have to be performed in thisarea it has been showed that there are possibilities to determine which pharmacological class asubstance belongs to by examining the morphological and metabolic patterns.

Background: Since the initiation of assisted reproduction techniques, several studies has been performed to improve treatment results by development of culture conditions like embryo oil and culture media used. In this study, two embryonic oils from different companies, Nidoil and Ovoil were examined.Method: In this study, 47 human embryos were used. All embryos were donated for research purposes by couples who had been treated at the clinic in Uppsala University Hospital. The embryos were divided into two groups, one group was cultured with Ovoil and the other with Nidoil.Results: There was no difference between the two oils, the embryo quality was the same in both groups.CONCLUSION: The result was expected because both oils had the same composition and purity.

Anaerobe opportunist Clostridium difficile causes the majority of hospital-acquired antibiotic-associated diarrhea. Infections can be severe because of its ability to withstand many antibiotics, to sporulate and to produce toxins (A, B and binary).     In Sundsvall Hospital C. difficile is detected with real-time PCR, which targets the sequences of toxin B, binary toxin and a regulatory gene deletion seen in the virulent ribotype 027. All positive samples are stored frozen for one month, available for further analysis or outbreak investigation. The aim of this study was to investigate if temperature and transportation time may affect the viability of C. difficile, and the PCR-result.     Frozen feces samples were cultivated, identified with MALDI-TOF and analyzed with real-time PCR after at least one month of storage. To simulate the effect of transportation time, samples were stored at 4-8°C for three and seven days before cultivation and identification. Controls were cultivated after freezing for comparison.     Ninety percent of the frozen samples contained viable C. difficile. Discrepancies between PCR-results were found for two of the oldest samples collected (six months), which turned negative. Fresh samples showed lower amount of viable C. difficile after three days (50 %) than after seven days (60 %) of storage, perhaps because of competition with other bacteria and sporulation. The frozen control group contained a higher viable amount, 75 %. The results indicate that C. difficile tolerates to be stored at low temperatures as practiced today at the laboratory. Transportation time seem to affect the outcome of cultivation, but not the PCR-result.

Leukocyte differential count in peripheral blood smear has, ever since the method was developed more than 100 years ago, been one of the most frequently used diagnostics tool in the routine hematology laboratory. The manual differential count of leukocytes using a microscope is still the standard method in most small and medium sized laboratories. Even though the method does not require any expensive instruments it comes at a high cost due to it being labor intensive and time consuming. In recent years the rapid technical advancements has led to the development of automatic or semi-automatic methods in which the leukocytes are differentiated. In this study a method comparison was made between manual leukocyte differential counts, CellaVision DM1200 Vet and Advia 2120 when analyzing 106 fresh, feline blood samples. The general agreement between results was good, especially for the most common leukocytes, such as neutrophils and lymphocytes. Results for eosinophils and monocytes had moderate agreement. The confidence intervals were generally wider when CellaVision DM1200 Vet was compared with Advia 2120, than when CellaVision DM1200 Vet was compared to the manual differential count. Despite the fact that Advia 2120 and CellaVision DM1200 Vet are both faster and often show comparable results to the manual differential count, the light microscopy will remain the gold standard for difficult samples, where there is suspicion of inflammation (band neutrophils), intracellular microorganisms, reactive lymphocytes or if the sample contains a high degree of smudge cells or artifacts.

The impact storage has on function of platelet concentrates is not completely known, although some factors have been discovered and measures have been taken to counteract them, such as adding platelet additive solution. There are several methods for analysing platelet function. In this study, the aim was to analyse change of platelet function in platelet concentrates over time and to see what effect fibrogen has on the coagulation. A technique using free oscillation rheometry (FOR), ReoRox®, was used to analyse function in platelet concentrates, both over time and after addition of fibrinogen. The platelets were analyzed at a concentration of 800 x109 Ptl/L and activated with thrombin receptor antigen peptide (TRAP). For fibrinogen efect analysis, four different concentrations were used, 10 g/L, 2,25 g/L, 1,0 g/L and 0,1 g/L. The results showed no statistically significant change in the function over time. However an increase in elasticity and decrease in the decline of elasticity could be seen. While analysing the platelets with fibrinogen it showed that up to 2,25 g/L the aggregation increased, while it decreased significantly at 10 g/L. In conclusion, the platelet concentrates retained a good clotting function from day one to day seven of storage, while the clot became stronger and fibrinolysis decreased. Fibrinogen proved important for coagulation, however a too high concentration inhibits coagulation.

Som svar på bakteriellt orsakade systemiskainfektioner och sepsis frisätts prohormonet prokalcitonin (PCT) till blodbanan.Analys av plasma-PCT (P-PCT) kan utföras med reagenset Elecsys BRAHMS PCT ianalysmodulerna cobas® e602 och e411från Roche Diagnostics.Analysprincipen är electrochemiluminiscence som bygger på immunanalys avsandwichprincip. Syftet med föreliggande studie var att verifiera metoden föranalys av P-PCT på Roche cobas® e602 och e411 med Elecsys BRAHMS PCT(ThermoFischer) samt att göra en hållbarhetsstudie av analyten ioriginalprovröret. Verifieringen gjordes genom mätning av repeterbarhet ochprecision, samt jämförelse av analysresultat från patientprover mot ett annatlaboratorium som använder samma analysmetod. Hållbarhetsstudien gjordes genomanalys av fem patientprover under olika tidsintervall 0-24 timmar efterprovtagning. Resultaten av repeterbarhetsstudien gavvariationskoefficientvärdet (CV) 3,5 % på Roche cobas® e602 medkontrollmaterial nivå 1 (åsatt värde 0,53 µg/L) och CV 1,3 % för kontrollmaterialnivå 3 (åsatt värde 24,5 µg/L). På Roche cobas e411 blev CV 2,2 % för nivå 1och 1,6 % för nivå 3. Precisionsstudien gav mellanliggande imprecisions CV-värdenmellan 1,2–1,9 % (Kontrollmaterial nivå 1 och 3). Patientjämförelserna visadeett linjärt samband (r>0,99). Bias tenderade att vara högre vidanalysresultat >20 µg/L. Hållbarhetsstudien resulterade i en obetydlig minskningav PCT koncentrationen från omedelbar analys (0,73; 57,7; 2,4; 0,94; 0,27 µg/L)och efter 24 timmar (0,70; 53,69; 2,21; 0,73; 0,24 µg/L). Repeterbarheten ochprecisionen för samtliga instrument bedömdes vara god. Patientjämförelsernavisade på ett tydligt linjärt samband med låg spridning, både vid analys iKalmar och i Linköping. Hållbarhetsstudien visade acceptabel hållbarhet avanalyten i originalprovröret. Metoden anses kunna införas på kliniskt kemiskalaboratorier vid Klinisk kemi och transfusionsmedicin, Landstinget i Kalmar län. / In response to bacterial systemic infections and sepsis, the prohormone procalcitonin (PCT) is released to the bloodstream. PCT levels in plasma can be measured using Elecsys BRAHMS PCT reagent with cobas® immunoanalyzer modules e602 and e411 from Roche Diagnostics. The test principle is electrochemiluminiscence immunoassay. The aim of this study was to verify the method for measuring plasma levels of PCT with Roche cobas® e602 and e411 using Elecsys BRAHMS PCT as well as to do a sustainability study of the analyte in the original sample tube. The verification was done by measurements of repeatability and precision, and a comparison of assay results from patient samples against another laboratory using the same method. The sustainability study was done by analyzing five patient samples during different time intervals 0-24 hours after sampling. The repeatability study gave coefficient of variations (CV %) values 3.5 % and 2.2 % with Roche cobas® e602 and 1.3 % and 1.6 % with Roche cobas® e411 using quality control level 1 (affixed value 0,53 µg/L) and level 3 (affixed value 24,5 µg/L) respectively. The precision study gave CV% values between 1.2-1.9 % (quality control level 1 and 3). The patient comparison study showed linear regression (r>0,99). Bias tended to be higher on assay results >20 µg/L. The sustainability study resulted in a slight decrease of the plasma PCT level from immediate analysis (0.73; 57.78; 2.41; 0.94; 0.27 µg/L) to analysis after 24 hours (0.70; 53.69; 2.21; 0.73; 0.24 µg/L). The repeatability and precision was considered to be good. Patient comparisons showed a clear linear relationship with little distribution between the values, both in Kalmar and in Linköping. The sustainability study showed an acceptable sustainability of the analyte in the original sample tube. This method is considered accurate and will be introduced to the laboratories of Clinical Chemistry and Transfusion Medicine at county council of Kalmar.